Objective To evaluate the prognostic value of microsatellite instability(MSI),preoperative D-dimer(DD),and CA19-9 level for the prognosis of colorectal cancer(CRC)patients who had undergone radical resection.Methods Retrospectively analyzed the general clinical data,MSI,DD,and CA19-9 levels of 81 CRC patients who underwent radical resection in the First Affiliated Hospital of Guangxi Medical University and Guilin People's Hospital between January 2020 and December 2021.Screen and evaluate prognostic factors.Results There was a statistically significant difference in the incidence of MSI,preoperative DD,and CA19-9 expression levels between recurrence group and non recurrence group(P＜0.05).There was a statistically significant difference in the incidence of MSI,preoperative DD,and CA19-9 expression levels between death group and survival group(P＜0.05).Univariate and multivariate analyses MSI was identified as a protective factor against recurrence(P=0.018),and high levels of preoperative DD and CA1 9-9 were identified as independent risk factors for recurrence(P=0.020,P=0.042).MSI was identified as a protective factor against mortality in CRC patients(P=0.036),and high levels of preoperative DD and CA19-9 were identified as independent risk factors for mortality in CRC patients(P=0.010,P=0.017).The receiver operating characteristic curve showed that the area under the curve(AUC)of MSI,DD,and CA19-9 for predicting recurrence after CRC surgery were 0.643,0.599,and 0.644 respectively,for mortality,they were 0.646,0.642,and 0.693 respectively.The combined model for predicting recurrence and mortality yielded AUC were 0.776 and 0.825,respectively.Conclusion MSI is a protective factor for prognosis in CRC patients,whereas high levels of preoperative DD and CA19-9 are risk factors for poor prognosis.The combined detection of these three factors can optimize the risk stratification of CRC.

Objective:To explore the impacts of smoking on the need for respiratory support and mortality in patients hospitalized with pneumonia.Methods:A total of 24 367 patients hospitalized with pneumonia from 2009 to 2017 in the China Kadoorie Biobank, were included. Smoking status was self-reported, and data regarding respiratory support during hospitalization and mortality during follow-up were obtained from medical claims and death registries, respectively. OR, HR, and 95% CI were calculated and adjusted for potential confounders using logistic regression models and Cox proportional hazards regression models, respectively. Results:Among males, current smokers or those who quit smoking due to illness had higher risks of requiring respiratory support ( OR=1.15, 95% CI: 1.03-1.29), 1-year mortality ( HR=1.66, 95% CI: 1.32-2.08), and 5-year mortality ( HR=1.32, 95% CI: 1.13-1.54) following pneumonia hospitalization compared to nonsmokers. Male smokers who started smoking at a younger age or with longer smoking duration had the highest mortality risks (trend test both P<0.05). Female current smokers or those who quit smoking due to illness had higher risks of 1-year mortality ( HR=1.62, 95% CI: 1.17-2.23) and 5-year mortality ( HR=1.33, 95% CI: 1.06-1.67). We found no statistically significant difference in 90-day mortality between current smokers/those who quit smoking due to illness and nonsmokers. Conclusions:Smoking was associated with higher risks of requiring respiratory support and mortality in patients hospitalized with pneumonia, especially among males and heavy smokers. These findings highlight the need for targeted strategies to promote smoking cessation in patients hospitalized with pneumonia.

Objective:To explore the impacts of smoking on the need for respiratory support and mortality in patients hospitalized with pneumonia.Methods:A total of 24 367 patients hospitalized with pneumonia from 2009 to 2017 in the China Kadoorie Biobank, were included. Smoking status was self-reported, and data regarding respiratory support during hospitalization and mortality during follow-up were obtained from medical claims and death registries, respectively. OR, HR, and 95% CI were calculated and adjusted for potential confounders using logistic regression models and Cox proportional hazards regression models, respectively. Results:Among males, current smokers or those who quit smoking due to illness had higher risks of requiring respiratory support ( OR=1.15, 95% CI: 1.03-1.29), 1-year mortality ( HR=1.66, 95% CI: 1.32-2.08), and 5-year mortality ( HR=1.32, 95% CI: 1.13-1.54) following pneumonia hospitalization compared to nonsmokers. Male smokers who started smoking at a younger age or with longer smoking duration had the highest mortality risks (trend test both P<0.05). Female current smokers or those who quit smoking due to illness had higher risks of 1-year mortality ( HR=1.62, 95% CI: 1.17-2.23) and 5-year mortality ( HR=1.33, 95% CI: 1.06-1.67). We found no statistically significant difference in 90-day mortality between current smokers/those who quit smoking due to illness and nonsmokers. Conclusions:Smoking was associated with higher risks of requiring respiratory support and mortality in patients hospitalized with pneumonia, especially among males and heavy smokers. These findings highlight the need for targeted strategies to promote smoking cessation in patients hospitalized with pneumonia.

Objective To evaluate the prognostic value of microsatellite instability(MSI),preoperative D-dimer(DD),and CA19-9 level for the prognosis of colorectal cancer(CRC)patients who had undergone radical resection.Methods Retrospectively analyzed the general clinical data,MSI,DD,and CA19-9 levels of 81 CRC patients who underwent radical resection in the First Affiliated Hospital of Guangxi Medical University and Guilin People's Hospital between January 2020 and December 2021.Screen and evaluate prognostic factors.Results There was a statistically significant difference in the incidence of MSI,preoperative DD,and CA19-9 expression levels between recurrence group and non recurrence group(P＜0.05).There was a statistically significant difference in the incidence of MSI,preoperative DD,and CA19-9 expression levels between death group and survival group(P＜0.05).Univariate and multivariate analyses MSI was identified as a protective factor against recurrence(P=0.018),and high levels of preoperative DD and CA1 9-9 were identified as independent risk factors for recurrence(P=0.020,P=0.042).MSI was identified as a protective factor against mortality in CRC patients(P=0.036),and high levels of preoperative DD and CA19-9 were identified as independent risk factors for mortality in CRC patients(P=0.010,P=0.017).The receiver operating characteristic curve showed that the area under the curve(AUC)of MSI,DD,and CA19-9 for predicting recurrence after CRC surgery were 0.643,0.599,and 0.644 respectively,for mortality,they were 0.646,0.642,and 0.693 respectively.The combined model for predicting recurrence and mortality yielded AUC were 0.776 and 0.825,respectively.Conclusion MSI is a protective factor for prognosis in CRC patients,whereas high levels of preoperative DD and CA19-9 are risk factors for poor prognosis.The combined detection of these three factors can optimize the risk stratification of CRC.

African swine fever(ASF)is an acute and highly pathogenic hemorrhagic disease of pigs,causing huge economic losses to pig industry.In order to quantitatively detect clinical samples of ASF and inactivated ASFV antigens,the IgG of ASF positive serum was used as capture anti-body and the HRP-labeled p72 monoclonal antibody was used as detecting antibody.The standard curve was drawn with the cell-cultured ASFV,and a sandwich ELISA detection of antigen was es-tablished.The specificity,sensitivity and stability of the method were evaluated.The effects of dif-ferent inactivation methods and adjuvant addition on antigen detection were further evaluated.The results showed that the minimum detection limits of the recombinant protein and the ASFV were 0.1 mg/L and 103.7 TCID50/mL,respectively.There was no cross-reaction with five common porcine pathogenic viruses,and the coefficient variations between batches was less than 10％.The total co-incidence rate with real-time fluorescence quantitative PCR was 92％(23/25).The sensitivity of antigen detection was significantly reduced when antigen was treated by BEI inactivation,and the detection results were severely interfered by aluminum adjuvant and nano-adjuvant.In summary,the sandwich ELISA antigen detection method established is specific,sensitive,and repeatable,with a good consistency to the qPCR method,which provides an effective clinical diagnostic meth-od for ASFV antigen.

Objective To investigate the job burnout of medical staff during long voyage in a navy warship troop and its influencing factors.Methods A total of 141 medical staff,who participated in a long voyage between January 2021 and December 2021,were consecutively included for surveys about basic information,job burnout,sleep quality,and regulation mode.Univariate and multivariate analyses were used to explore influencing factors for job burnout.Results The proportion of mild and below job burnout and moderate to severe job burnout in the cohort was 45.39%and 54.61%,respectively.Univariate analysis showed that married status,Master's or Doctor's degree,moderate to heavy workload,no psychological training experience,sleep disorder and low-exercise regulation mode were significant influencing factors for job burnout(P<0.05).Multivariate analysis showed that married status,Master's or Doctor's degree,sleep disorder and low-exercise and high-evaluation regulation mode were independent risk factors for job burnout(P<0.05).However,psychological training experience was considered to be a significant protective factor(P= 0.021).Conclusion Medical staff in a navy warship troop experiences severe job burnout during long voyage.The people who are married,have a Master's or Doctor's degree,have sleep disorder and low-exercise and high-evaluation regulation mode are more likely to experience job burnout,which should be paid more attention to.

Objective:To preliminarily compare the effectiveness of different end-effectors on upper limb motor function im-provement in chronic stroke patients undergoing motor imagery-based brain-computer interface(BCI) rehabilitation. Method:Thirty-two chronic stroke patients who received motor imagery-based BCI rehabilitation were includ-ed. Based on the BCI training received,patients were divided into two groups:BCI combined with virtual re-ality feedback and BCI combined with wrist joint robot feedback. Assessment of upper limb motor function (upper limb Fugl-Meyer assessment),active range of motion of the paralyzed wrist,surface electromyography reflecting active contraction of wrist extensor muscles,and motor-evoked potentials (MEP) were conducted be-fore and after intervention. Thus,to compare the impact of virtual reality feedback and wrist joint robot feed-back on upper limb motor function recovery in chronic stroke patients.Result:Prior to intervention,baseline results were comparable between the two groups(P=0.160). After inter-vention,significant improvements in upper limb motor function were observed in both groups (P<0.001). The wrist joint robot feedback group showed a trend significant improvement in Fugl-Meyer scores and the changes in Fugl-Meyer scores compared to the virtual reality feedback group (P=0.06). Regarding active range of mo-tion of the paralyzed wrist,both groups initially lacked active flexion-extension movements,and after interven-tion,the improvement was 33.13°±24.96° in the wrist joint robot group and 27.81°±37.17° in the virtual reali-ty group,with no significant difference between the two groups (P>0.638). In the assessment of surface elec-tromyography for wrist extensor muscle group on the paralyzed side,both groups showed significant improve-ment in average amplitude and area under the curve after intervention (P<0.001),with the wrist joint robot group demonstrating a more significant improvement in average amplitude(P<0.001),while area under curve showed a trend of improvement. In the MEP evaluation,the elicitation rate after intervention was 56.25％ in the wrist joint robot group and 18.75％ in the virtual reality group. Conclusion:Motor imagery-based BCI rehabilitation systems effectively improve upper limb motor function in chronic stroke patients. Wrist joint robot feedback appears to be more significant in improvement compared to virtual reality feedback. Integrating sensory and motor information might better affect upper limb motor recov-ery. These might help to optimize the feedback strategy of BCI training.

Objective:To preliminarily compare the effectiveness of different end-effectors on upper limb motor function im-provement in chronic stroke patients undergoing motor imagery-based brain-computer interface(BCI) rehabilitation. Method:Thirty-two chronic stroke patients who received motor imagery-based BCI rehabilitation were includ-ed. Based on the BCI training received,patients were divided into two groups:BCI combined with virtual re-ality feedback and BCI combined with wrist joint robot feedback. Assessment of upper limb motor function (upper limb Fugl-Meyer assessment),active range of motion of the paralyzed wrist,surface electromyography reflecting active contraction of wrist extensor muscles,and motor-evoked potentials (MEP) were conducted be-fore and after intervention. Thus,to compare the impact of virtual reality feedback and wrist joint robot feed-back on upper limb motor function recovery in chronic stroke patients.Result:Prior to intervention,baseline results were comparable between the two groups(P=0.160). After inter-vention,significant improvements in upper limb motor function were observed in both groups (P<0.001). The wrist joint robot feedback group showed a trend significant improvement in Fugl-Meyer scores and the changes in Fugl-Meyer scores compared to the virtual reality feedback group (P=0.06). Regarding active range of mo-tion of the paralyzed wrist,both groups initially lacked active flexion-extension movements,and after interven-tion,the improvement was 33.13°±24.96° in the wrist joint robot group and 27.81°±37.17° in the virtual reali-ty group,with no significant difference between the two groups (P>0.638). In the assessment of surface elec-tromyography for wrist extensor muscle group on the paralyzed side,both groups showed significant improve-ment in average amplitude and area under the curve after intervention (P<0.001),with the wrist joint robot group demonstrating a more significant improvement in average amplitude(P<0.001),while area under curve showed a trend of improvement. In the MEP evaluation,the elicitation rate after intervention was 56.25％ in the wrist joint robot group and 18.75％ in the virtual reality group. Conclusion:Motor imagery-based BCI rehabilitation systems effectively improve upper limb motor function in chronic stroke patients. Wrist joint robot feedback appears to be more significant in improvement compared to virtual reality feedback. Integrating sensory and motor information might better affect upper limb motor recov-ery. These might help to optimize the feedback strategy of BCI training.

Background::Reperfusion therapy is fundamental for ST-segment elevation myocardial infarction (STEMI). However, the details of contemporary practice and factors associated with reperfusion therapy in China are largely unknown. Therefore, this study aimed to explore reperfusion practice and its associated factors among hospitalized patients with STEMI in China.Methods::Patients with STEMI who were admitted to 159 tertiary hospitals from 30 provinces in China were included in the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome project from November 2014 to December 2019. The associations of the characteristics of patients and hospitals with reperfusion were examined using hierarchical logistic regression. The associations between therapies and in-hospital major adverse cardiovascular events were examined with a mixed effects Cox regression model.Results::Among the 59,447 patients, 37,485 (63.1%) underwent reperfusion, including 4556 (7.7%) receiving fibrinolysis and 32,929 (55.4%) receiving primary percutaneous coronary intervention (PCI). The reperfusion rate varied across geographical regions (48.0%-73.5%). The overall rate increased from 60.0% to 69.7% from 2014 to 2019, mainly due to an increase in primary PCI within 12 h of symptom onset. Timely PCI, but not fibrinolysis alone, was associated with a decreased risk of in-hospital major adverse cardiovascular events compared with no reperfusion, with an adjusted hazard ratio (95% confidence interval) of 0.64 (0.54,0.76) for primary PCI at <12 h, 0.53 (0.37,0.74) for primary PCI at 12 to 24 h, 0.46 (0.25,0.82) for the pharmaco-invasive strategy, and 0.79 (0.54,1.15) for fibrinolysis alone.Conclusions::Nationwide quality improvement initiatives should be strengthened to increase the reperfusion rate and reduce inequality in China.Trial registration::www.ClinicalTrials.gov, NCT02306616

Objective:To investigate the relationship between genotype and phenotype in children with CRB1 mutated Leber congenital amaurosis (LCA) and early onset retinal dystrophy (EOSRD). Methods:A retrospective clinical study. From January 2013 to December 2019, 10 children with CRB1 mutated LCA/EOSRD were enrolled in the study. The patients were identified as CRB1 mutation by the second generation targeted capture sequencing, Sanger sequencing and the family segregation analysis. All children underwent electroretinogram (ERG) and fundus examination. At the same time, 6 cases were examined by optical coherence tomography (OCT); 1 case was examined by fluorescein fundus angiography (FFA), 7 cases were examined by wide-angle laser scanning ophthalmoscope (UWF SLO). Results:There were 6 cases of LCA and 4 cases of EOSRD in 10 patients with CRB1 gene mutations. The average age of first visit was 3.61 years old. The light and dark wave of ERG was flat in 6 cases, and decreased in 4 cases. A total of 19 pathogenic mutations were detected. There were 1 homozygous mutation and 9 compound heterozygous mutations. There were 4, 2 and 1 cases of "copper-coin" like, "salt and pepper" like and "osteocyte" like pigment changes in retina, 1 case of "crystalline pigment" change and 2 cases of macular pigment scar. In 7 cases of UWF SLO examination, different degrees of para-arteriolar pigment epithelium retention (PPRPE) were found in the middle and peripheral fundus. In 6 cases examined by OCT, the outer layer of retina atrophied and the band of ellipsoid disappeared. Symmetrical cystoid macular edema, splitting cystoid macular degeneration and adhesion of epi-macular membrane to optic disc and macular area were found in 1 case, respectively, the retinal structure was rough and thickened, and the fovea became thinner in 3 cases. In FFA examination, 1 case showed uveitis-like changes with late optic disc fluorescein staining, macular fluorescence accumulation, strong fluorescence diffusing along the blood vessels in each quadrant, peripheral PPRPE of "frost-branch" like strong fluorescence. Conclusion:The relationship between genotype and phenotype of CRB1 mutation is complex, and PPRPE is a common characteristic change.